1. Field of the Invention
This invention relates broadly to surgical devices. More particularly, this invention relates to a surgical clip for clamping and/or suturing, ducts, vessels, and other tissues, for anchoring a tissue, or for attaching a foreign body to a tissue.
2. State of the Art
Surgical clips are generally used to apply clamping force to ducts, vessels, and other tissues. In addition, surgical clips are particularly useful in controlling bleeding of a tissue in lieu of suturing or stapling where suturing or stapling is difficult. However, in certain circumstances, the bleeding tissue is lubricous, and applied clips often slip from the tissue and are dislodged, removing the necessary clamping force thereabout. This is particularly a problem when a clip is provided about tissue which is not a conduit of a size which can be completely surrounded by the clip. For example, it is very difficult to secure a clip about a small peripheral portion of ulcerated stomach tissue and therefore it is difficult to effect hemostasis of such bleeding tissue with a clip. Moreover, the problem is amplified when the clip used is very small.
In order to prevent dislodgement, a combination of a clip and a staple has been described in U.S. Pat. No. 5,522,823 to Kuntz et al. In the Kuntz clip, one end portion of the clip is pierced through the tissue and captured in an eye of another end portion of the clip to secure the clip on the tissue. With the clip piercing the tissue, the likelihood that the clip will become inadvertently dislodged is greatly reduced.
While the Kuntz et al. clip represents a step forward, the disclosed clip is not particularly useful in endoscopic procedures. In particular, both the nature of the clip and the manner in which it is applied are complex. For example, in order to facilitate the bending of the clip through various configurations required of its applier, the clip has portions provided with at least four different widths as well as an eye opening. This complex clip structure is not practical for a clip which is to be used in a flexible endoscopy procedure in which the tools used are of very small diameter, e.g., 2-6 mm (0.08-0.24 inch). In addition, for endoscopic procedures it is highly desirable that multiple clips be able to be applied without removing the clip applier from its general location. The Kuntz et al. clip and applier, however, are not particularly adapted for applying multiple clips, as the Kuntz et al. clip does not stack, and the applier with which it is used holds a single clip at a time.
It is therefore an object of the invention to provide a surgical clip which remains secured to the tissue to which it is applied.
It is another object of the invention to provide a surgical clip which pierces tissue in order to maintain a secure hold on the tissue to which it is applied.
It is a further object of the invention to provide a surgical clip which is adapted for use in minimally invasive surgery.
It is an additional object of the invention to provide a surgical clip which can be applied in a flexible endoscopy setting.
It is also an object of the invention to provide a surgical clip which can be used with rigid instruments operated through a port in the human body.
It is yet another object of the invention to provide a surgical clip which can be used in open surgery.
It is still a further object of the invention to provide a surgical clip which is relatively easy to manufacture.
It is still another object of the invention to provide a surgical clip which is particularly adapted for use in an applier which holds a plurality of clips.
In accord with these objects, which will be discussed in detail below, a surgical clip is provided having a generally U-shaped configuration with first and second arms, and a bridge portion therebetween. The first arm is provided with a tip preferably having one or more catches, and the second arm extends into a deformable retainer preferably having a tissue-piercing end and preferably also a hook. During application, the clip is forced over compressed tissue. As the clip is forced over the tissue, the retainer of the second arm is bent and may pierce through the tissue. The retainer is preferably sized to be bent sufficiently toward and around the tip of the first arm until the hook engages in one of the catches to secure the clip to the tissue and prevent the clip and tissue from separating. In other embodiments, the clip includes neither the hook nor the catch; the retainer is simply bent to pierce the tissue and preferably folded about the tip of the first arm to prevent the clip and tissue from separating. In yet another embodiment, the clip includes a plurality of retainers which are bent to aid in securing the clip to or about tissue.
According to a preferred aspect of the invention, the clip is provided with structure that facilitates the stacking (or chaining) of a plurality of clips in a clip chamber of an applier. The structure includes: a notch at a junction of the first arm and the bridge portion which is adapted to receive the tip of the first arm of another clip; an elongate recess along the exterior of the second arm which is adapted to receive the retainer of the second arm of another clip; and an interior configuration at the ends of the first and second arms which corresponds to an exterior portion of the bridge portion of another clip. The recess on the second arm may be provided adjacent the bridge portion or between a rear portion of the second arm and the retainer thereof.
Additional objects and advantages of the invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided figures.